Objective:To investigate the clinical distribution characteristics changes in antimicrobial resistance, and carbapenemase resistance genes of Klebsiella pneumoniae isolated from children in Chongqing region during the period of January 2019 to December 2024, providing a basis for the rational use of antibiotics and the prevention and control of nosocomial infections.Methods:An observational study was conducted to retrospectively analyze 5 020 Klebsiella pneumoniae (KP) isolates detected in four hospitals of the Southwest Pediatric Laboratory Specialty Alliance. Antimicrobial susceptibility testing was performed by the minimum inhibitory concentration method combined with the disk diffusion method. Results were interpreted according to the 2024 Clinical and Laboratory Standards Institute (CLSI) standards. Carbapenemase resistance genes were detected by polymerase chain reaction (PCR) combined with Sanger sequencing. WHONET 5.6 was used for resistance analysis and SPSS 19.0 for statistical analysis. The chi-square test was used to assess trends in resistance rates, ESBL detection rates, and resistance rates of different CRKP carbapenemase genotypes from 2019 to 2024. Statistical significance was confirmed if the two-tailed P-value was <0.05. Results:A total of 5 020 strains were isolated, with a detection rate of 5.1% (5 020/99 063). The majority were from sputum (59.2%, 2 970/5 020), followed by pus (17.1%, 857), urine (9.7%, 487), venous blood (6.5%, 326), secretions (2.6%, 130), and other specimens (5.0%, 250).The lowest resistance rate was to amikacin (3.8%), followed by levofloxacin (10.9%), imipenem (19.1%), and meropenem (19.9%). Resistance rates to cefoperazone/sulbactam ( χ2=9.982 0, P=0.001 6), piperacillin/tazobactam ( χ2=10.110 0, P=0.001 5), ceftazidime ( χ2=3.849 0, P=0.049 8), cefotaxime ( χ2=7.605 0, P=0.005 8), cefepime ( χ2=13.510 0, P=0.000 2), aztreonam ( χ2=6.457 0, P=0.011 1), imipenem ( χ2=4.672 0, P=0.030 7), and levofloxacin ( χ2=7.555 0, P=0.006 0) showed an annual increasing trend. The main carbapenemase genes were blaNDM-5 (42.2%, 127/301), blaNDM-1 (33.9%, 102/301), and blaKPC-2 (17.3%, 52/301). Patients with KPC-2-producing strains (median age, 240 days) were older than those with NDM-1/NDM-5-producing strains (median age, 40 days) ( χ2=22.620 0, P<0.000 1). In neonatal wards, the detection rate of NDM-KP was higher than that of KPC-KP (64.6%, 148/229 vs. 26.9%, 14/52, χ2=24.680 0, P<0.000 1), whereas in ICUs, it was lower (6.1%, 14/229 vs. 26.9%, 14/52, χ2=20.450 0, P<0.000 1). Conclusion:In Chongqing region, the isolation rate of K. pneumoniae from sputum was the highest with most cases from neonatal wards. Resistance to carbapenems showed an upward trend. BlaNDM-5 was the predominant genotype in pediatric CRKP. Patients with KPC-KP were older than those with NDM-KP. NDM-KP predominated in neonatal wards, while KPC-KP predominated in ICUs, with KPC-KP showing higher antimicrobial resistance.

Objective Text mining of content characteristics of original science popularization articles on the WeChat public account"PSM Medicine Shield Public Welfare"based on LDA model and Linear Regression.Methods Through web crawling techniques,we collected 4,292 original pharmaceutical science popularization articles and associated comment data from the"PSM Drug Shield Public Welfare"WeChat Official Account to analyze the content distribution patterns and characteristics of pharmaceutical science communication.Employing Latent Dirichlet Allocation(LDA)modeling,we systematically categorized and mined article themes to identify public demand for science literacy and explore strategic directions for precision-targeted phar-maceutical science dissemination.Results The analysis of 4 292 original science popularization articles from the"PSM Medi-cine Shield Public Welfare"account showed an average readership of 1 815.73±4 385.31.Articles in headline positions,pub-lished on weekends,or using exclamatory titles achieved higher readership.Most articles(1 000-2 000 words)used direct-open-ing title strategies.Traditional Chinese medicines had the highest readership among drug categories.Top content categories in-cluded drug monographs,medicinal diets,disease medication guidance,myth clarification,and disease science.Linear regres-sion analysis identified headline placement,word count,title phrasing,title strategy,target audience,drug category,and content type as potential factors influencing readership.The LDA model with 9 s revealed key themes:management of drug adverse reac-tions,dermatological medication dosing,anti-infection effects of medicinal diets,and pediatric vaccination/health monitoring.Conclusion The"PSM Medicine Shield Public Welfare"WeChat account primarily disseminates pharmaceutical science content focusing on adverse drug reactions,pediatric medication safety,TCM-based health preservation,disease treatment protocols,symptom recognition guidelines,dosage optimization,and toxicity management.Pharmaceutical professionals should prioritize content length control,evidence-based title strategies,and thematic alignment with public health priorities during science commu-nication content creation.

Objective Text mining of content characteristics of original science popularization articles on the WeChat public account"PSM Medicine Shield Public Welfare"based on LDA model and Linear Regression.Methods Through web crawling techniques,we collected 4,292 original pharmaceutical science popularization articles and associated comment data from the"PSM Drug Shield Public Welfare"WeChat Official Account to analyze the content distribution patterns and characteristics of pharmaceutical science communication.Employing Latent Dirichlet Allocation(LDA)modeling,we systematically categorized and mined article themes to identify public demand for science literacy and explore strategic directions for precision-targeted phar-maceutical science dissemination.Results The analysis of 4 292 original science popularization articles from the"PSM Medi-cine Shield Public Welfare"account showed an average readership of 1 815.73±4 385.31.Articles in headline positions,pub-lished on weekends,or using exclamatory titles achieved higher readership.Most articles(1 000-2 000 words)used direct-open-ing title strategies.Traditional Chinese medicines had the highest readership among drug categories.Top content categories in-cluded drug monographs,medicinal diets,disease medication guidance,myth clarification,and disease science.Linear regres-sion analysis identified headline placement,word count,title phrasing,title strategy,target audience,drug category,and content type as potential factors influencing readership.The LDA model with 9 s revealed key themes:management of drug adverse reac-tions,dermatological medication dosing,anti-infection effects of medicinal diets,and pediatric vaccination/health monitoring.Conclusion The"PSM Medicine Shield Public Welfare"WeChat account primarily disseminates pharmaceutical science content focusing on adverse drug reactions,pediatric medication safety,TCM-based health preservation,disease treatment protocols,symptom recognition guidelines,dosage optimization,and toxicity management.Pharmaceutical professionals should prioritize content length control,evidence-based title strategies,and thematic alignment with public health priorities during science commu-nication content creation.

Objective:To investigate the clinical distribution characteristics changes in antimicrobial resistance, and carbapenemase resistance genes of Klebsiella pneumoniae isolated from children in Chongqing region during the period of January 2019 to December 2024, providing a basis for the rational use of antibiotics and the prevention and control of nosocomial infections.Methods:An observational study was conducted to retrospectively analyze 5 020 Klebsiella pneumoniae (KP) isolates detected in four hospitals of the Southwest Pediatric Laboratory Specialty Alliance. Antimicrobial susceptibility testing was performed by the minimum inhibitory concentration method combined with the disk diffusion method. Results were interpreted according to the 2024 Clinical and Laboratory Standards Institute (CLSI) standards. Carbapenemase resistance genes were detected by polymerase chain reaction (PCR) combined with Sanger sequencing. WHONET 5.6 was used for resistance analysis and SPSS 19.0 for statistical analysis. The chi-square test was used to assess trends in resistance rates, ESBL detection rates, and resistance rates of different CRKP carbapenemase genotypes from 2019 to 2024. Statistical significance was confirmed if the two-tailed P-value was <0.05. Results:A total of 5 020 strains were isolated, with a detection rate of 5.1% (5 020/99 063). The majority were from sputum (59.2%, 2 970/5 020), followed by pus (17.1%, 857), urine (9.7%, 487), venous blood (6.5%, 326), secretions (2.6%, 130), and other specimens (5.0%, 250).The lowest resistance rate was to amikacin (3.8%), followed by levofloxacin (10.9%), imipenem (19.1%), and meropenem (19.9%). Resistance rates to cefoperazone/sulbactam ( χ2=9.982 0, P=0.001 6), piperacillin/tazobactam ( χ2=10.110 0, P=0.001 5), ceftazidime ( χ2=3.849 0, P=0.049 8), cefotaxime ( χ2=7.605 0, P=0.005 8), cefepime ( χ2=13.510 0, P=0.000 2), aztreonam ( χ2=6.457 0, P=0.011 1), imipenem ( χ2=4.672 0, P=0.030 7), and levofloxacin ( χ2=7.555 0, P=0.006 0) showed an annual increasing trend. The main carbapenemase genes were blaNDM-5 (42.2%, 127/301), blaNDM-1 (33.9%, 102/301), and blaKPC-2 (17.3%, 52/301). Patients with KPC-2-producing strains (median age, 240 days) were older than those with NDM-1/NDM-5-producing strains (median age, 40 days) ( χ2=22.620 0, P<0.000 1). In neonatal wards, the detection rate of NDM-KP was higher than that of KPC-KP (64.6%, 148/229 vs. 26.9%, 14/52, χ2=24.680 0, P<0.000 1), whereas in ICUs, it was lower (6.1%, 14/229 vs. 26.9%, 14/52, χ2=20.450 0, P<0.000 1). Conclusion:In Chongqing region, the isolation rate of K. pneumoniae from sputum was the highest with most cases from neonatal wards. Resistance to carbapenems showed an upward trend. BlaNDM-5 was the predominant genotype in pediatric CRKP. Patients with KPC-KP were older than those with NDM-KP. NDM-KP predominated in neonatal wards, while KPC-KP predominated in ICUs, with KPC-KP showing higher antimicrobial resistance.

OBJECTIVE To systematically evaluate the real-world effectiveness and safety of belimumab in the treatment of lupus nephritis （LN） in Chinese adult patients. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Wanfang data， CNKI， VIP and CBM， real-world studies on belimumab in the treatment of LN in Chinese adult patients were collected from the inception to July 7th， 2023. Two reviewers independently screened the literature， extracted data， and assessed the quality of the included studies. Meta-analysis was then performed using RevMan 5.3 software. RESULTS A total of 10 real- world studies were included， involving 253 Chinese adult patients with LN. The results of the meta-analysis demonstrated that the complete renal response rate， partial renal response rate， and the incidence of adverse reaction rate in Chinese adult patients with LN treated with belimumab were 61% （95%CI was 46%-76%， P＜0.000 01）， 23%（95%CI was 2%-44%， P＝0.03）， and 30% （95%CI was 16%-43%， P＜0.000 01）， respectively. Belimumab could reduce the 24-hour urinary protein （MD＝－1.71， 95%CI was －3.02-－0.40， P＝0.01）， urine protein-creatinine ratio （MD＝－1.76，95%CI was －2.06-－1.46，P＜0.000 01）， the systemic lupus erythematosus disease activity index （MD＝－8.63， 95%CI was －12.12-－5.13， P＜0.000 01）， and glucocorticoids dosage （MD＝－18.65， 95%CI was －31.82-－5.48， P＝0.006）. In addition， it could elevate the levels of complement C3 （MD＝0.19， 95%CI was 0.08-0.30， P＝0.000 6） and complement C4 （MD＝0.06， 95%CI was 0.02-0.09， P＝0.001）. However， belimumab could not improve the levels of serum creatinine and estimated glomerular filtration rate （P＞0.05）. CONCLUSIONS Belimumab has good efficacy and safety in Chinese adult patients with LN.

OBJECTIVE To explore the effect and mechanism of Huanglian Jiedu decoction in reducing inflammation of abscess from the perspective of lncRNA NEAT1. METHODS C57BL/6 mice were divided into blank group, model group, Huanglian Jiedu decoction group and control group. After the intervention, the tissue were separated and collected under anesthesia. Animal experiment: the wound tissue of each group was observed by morphology. Real-time PCR and Western blotting were used to detect lncRNA NEAT1, miR-146a-5p gene level changes and RELA, TNF-α, TGF-β1, α-SMA, Collagen Ⅲ protein expression respectively. Cell experiments: Real-time PCR was used to detect the changes of lncRNA NEAT1 and miR-146a-5p gene levels. The effect of flow cytometry on apoptosis rate was detected. Fluorescence intensity was measured by FISH. The expression of related proteins was detected by Western blotting. RESULTS Compared with model and control group, the wound was repaired well and the inflammatory cell infiltration in the wound of the Huanglian Jiedu decoction group was reduced. Compared with the model and control group, the level of lncRNA NEAT1 and protein expressions of RELA, TNF-α, TGF-β1 in the Huanglian Jiedu decoction group were significantly reduced, while the gene level of miR-146a-5p and the protein expressions of α-SMA and Collagen III were significantly increased(P<0.05). Compared with LPS+Lenti-control group, lncRNA NEAT1 gene level in LPS+Lenti-sh-NEAT1 group was significantly decreased, while miR-146a-5p gene level was increased(P<0.05). Flow cytometry showed that Huanglian Jiedu decoction could reduce the apoptosis rate and fluorescence intensity of lncRNA NEAT1(P<0.05). Compared with the blank group, the protein expressions of RELA, TNF-α, TGF-β1 in LPS group were significantly increased, while the protein expressions of α-SMA and Collagen III were significantly decreased (P<0.05). After sh-NEAT1 treatment, The regulatory effects of Huanglian Jiedu decoction on the expression of above molecule were reduced(P<0.05). CONCLUSION Huanglian Jiedu decoction can alleviate the inflammatory state of mouse abscess wound through lncRNA NEAT1, which is closely related to the regulation of miR-146a, RELA, TNF-α, TGF-β1, α-SMA and Collagen III expression.

Duchenne muscular dystrophy (DMD) is a serious and progressive hereditary muscle disease. The DMD gene mutation on the X chromosome causes the loss of dystrophin, causing progressive muscle weakness and muscular atrophy. Most patients die for heart and lung failure. Current gene therapy methods are mainly aimed at restoring the expression of dystrophin, including read-through therapy, exon skipping therapy, vector-mediated gene replacement therapy and gene editing therapy. This article reviews the mechanisms of these different treatments and important advances in clinical research, and analyzes the challenges and application prospects of these treatments.

Objective:To investigate the correlation between serum CXCL12 and the outcomes after intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods:Consecutve patients with acute ischemic stroke treated with intravenous thrombolytic therapy in the Department of Neurology, the First Affiliated Hospital of Soochow University from January 1, 2020 to August 31, 2021 were enrolled retrospectively. Serum CXCL12 was measured by enzyme-linked immunosorbent assay within 24 h of onset. No improvement in early neurological function was defined as the National Institutes of Health Stroke Scale (NIHSS) 24 h after thrombolysis decreased by <4 compared with the baseline. The clinical outcome was evaluated by the modified Rankin Scale at 90 d after onset, and >2 were defined as a poor outcome. Multivariate logistic regression analysis was used to evaluate the correlation between serum CXCL12 and the outcome after intravenous thrombolysis, and the predictive value of serum CXCL12 for no improvement of early neurological function and poor short-term outcome was analyzed by the receiver operating characteristic (ROC) curve. Results:A total of 66 patients were enrolled, and the serum CXCL12 was 15.72±6.52 g/L. Twenty-seven patients (40.9%) had poor outcomes, and 34 (51.5%) had no improvement in early neurological function. Multivariate logistic regression analysis showed that higher serum CXCL12 was an independent predictor of poor outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.093-1.419; P=0.001) and no improvement in early neurological function ( OR 1.250, 95% CI 1.100-1.420; P=0.001). ROC curve analysis showed that the area under the curve of serum CXCL12 for predicting poor outcome was 0.793 (95% CI 0.679-0.908), the best cut-off value was 15.38 μg/L, and the corresponding sensitivity and specificity were 81.5% and 76.9%, respectively. The area under the curve of serum CXCL12 for predicting no improvement of early neurological function was 0.849 (95% CI 0.748-0.951), and the best cut-off value was 15.68 μg/L, and the corresponding sensitivity and specificity were 76.5% and 87.5%, respectively. Conclusion:Serum CXCL12 had a better predictive value for the outcomes of patients with acute ischemic stroke after intravenous thrombolytic therapy.

Objective:To improve awareness about infratentorial dural arteriovenous fistula (DAVF).Methods:Three cases of DAVF in the First Affiliated Hospital of Soochow University from September 2017 to September 2019 were retrospectively analyzed in terms of clinical features, cerebrospinal fluid (CSF) analysis, brain imaging and treatment, and followed up through telephone call.Results:Case 1: A 43-year-old woman, in chronic but acute aggravated course, presented with weakness of both lower limbs and urination and defecation dysfunction. Brain magnetic resonance imaging (MRI) revealed abnormal signal in medulla. CSF analysis demonstrated aquaporin-4 antibodies positive. Misdiagnosed as neuromyelitis optica spectrum disorders, the treatment was poor. Then digital subtraction angiography (DSA) showed DAVF at the left infratentorial area, and endovascular treatment was operated. Relapse was not observed in two-year follow up. Case 2: A 57-year-old woman, in chronic progressive course, mainly manifested as memory loss, but progressed with dysphagia, fever, coma. Treatment as “central nervous infection” was poor. Then DSA showed DAVF at the bilateral transverse-sigmoid sinus area, and endovascular treatment was operated with embolized partial fistulas. The patient died from lung infection within two months. Case 3: A 52-year-old man, in subacute course, was treated in the Gastroenterology Department with clinical manifestion of stubborn nausea and vomiting. Brain MRI revealed abnormal signal in medulla, with prominent vessel flow voids nearby. Then DSA showed DAVF at the craniocervical junction, and endovascular treatment was operated. Relapse was not observed in six-month follow up.Conclusions:DAVF has a variety of clinical manifestations, and infratentorial DAVF can manifest as acute neurological dysfunction involving the brain stem, cerebellum, spinal cord, which may be easily misdiagnosed. When brain MRI showed intracranial abnormal signal, the possibility of DAVF should be considered. DSA remains the gold standard to diagnose DAVF. Endovascular embolization is the main treatment of infratentorial DAVF at present. Prognosis depends on clinical presentation and fistula classification.

Objective To explore the characteristics of resting-state functional connectivity in male adults with attention deficit hyperactivity disorder (ADHD) and the relationship with clinical symptoms.Method Forty-seven male adult ADHD patients diagnosed by DSM-Ⅳ-TR and 47 healthy controls matched with sex,age and IQ were enrolled by clinical interviews.All subjects underwent structural MRI scan and resting-state functional MRI scan.All subjects were rated the ADHD symptom severity with the ADHD symptom rating scale.A two independent-samples t-test was used to analyze the differences of the resting-state functional connectivity strength (FCS) between the male adult ADHD group and the healthy control group.Results Compared with healthy controls,adult ADHD patients had shown the reduced FCS in the right middle temporal gyrus(t=-3.42),inferior temporal gyrus (t=-3.32),right middle occipital gyrus (t=-3.11) and inferior occipital gyrus (t=-4.44,P＜0.05 after multiple correction).The FCS of right inferior occipital gyrus in ADHD group had a tendency to negatively correlated with the severity of symptoms (r=-0.403,P＜0.05).A trend of negative correlation between the FCS in the right inferior occipital gyrus in ADHD group and the attention deficit score was found (r=-0.507,P＜0.05).Conclusion Abnormalities in resting-state brain function connectivity are prominent in male adult ADHD patients.Occipitallobe dysfunction may be more related to the severity of the ADHD symptoms.Temporal lobe and occipital lobe seem to be crucial to the pathogenesis of adult male ADHD.